Flank and groin pain: causes and next steps

Flank pain is felt along the side of the trunk, while groin pain sits where the abdomen meets the upper thigh. A pulled abdominal, hip-flexor, or inner-thigh muscle can cause pain after sport or a sudden movement. Hip impingement, a labral tear, or hip osteoarthritis may cause groin pain with turning, squatting, sitting, or walking. Kidney or urinary problems, bowel conditions, or a hernia can also produce pain in this region, so associated symptoms and examination guide the next step.

Until the cause is clearer, reduce movements that sharply increase pain, avoid heavy lifting, and use comfortable walking rather than prolonged complete rest. Note whether symptoms follow exercise, hip rotation, meals, urination, or coughing. A clinician may check hip range, abdominal tenderness, strength, gait, and the back, then decide whether imaging or other tests are appropriate. Sports physiotherapy may help a confirmed muscle or movement-related problem with graded strengthening and a careful return to activity.

Seek prompt care for flank or groin pain with fever, vomiting, blood in urine, painful urination, a new groin lump, testicular or pelvic pain, or difficulty passing urine or stool. Urgent help is needed for severe sudden pain, fainting, a rigid abdomen, or inability to walk after injury.

Could this be coming from my hip, abdominal wall, back, urinary system, or a hernia? What examination or tests do I need? Which activities are safe while waiting? What change in symptoms should prompt urgent review?